Obesity drives US healthcare costs up by 29 percent, varying by state: study

12 Feb 2018 --- New research from Cornell University is providing an insight into how individual states are affected by the healthcare costs of obesity. Using microdata for each state, researchers have for the first time estimated the percentage of healthcare spending that is devoted to obesity.

Large differences exist across states, says John Cawley, professor of policy analysis and management. 

“In 2015, states such as Arizona, California, Florida, New York and Pennsylvania devoted 5 to 6 percent of their total medical expenditures to treating obesity-related illness, whereas North Carolina, Ohio and Wisconsin spent more than twice that – over 12 percent of all healthcare dollars in those states were used to treat obesity-related illness."

Overall, the authors found the percent of US national medical expenditures devoted to treating obesity-related illness in adults rose from 6.13 percent in 2001 to 7.91 percent in 2015, an increase of 29 percent.

The publication reports results by payer type, including private health insurance companies, Medicare and Medicaid.

“Once again, we find dramatic differences across states in the fraction of Medicaid spending that is devoted to obesity-related illness,” Cawley says. “For example, over 2001-2015, Kentucky and Wisconsin devoted over 20 percent of their Medicaid spending to obesity-related illness. In contrast, in New York, 10.9 percent of Medicaid spending was devoted to obesity-related illness, and the average for the US as a whole was 8.23 percent during that period.”

By analyzing data for 2001-2015 from the Medical Expenditure Panel Survey, a nationally representative survey of Americans' healthcare utilization and costs, the authors estimated the percent of healthcare costs that were associated with adult obesity for the most populous states.

Estimates could not be generated for less populous states because of a scarcity of information about their residents in the data. Previous estimates of the healthcare costs of obesity by state were not based on microdata for each state but on assumptions about how national costs should be apportioned to different states.

These differences across states are driven by a number of factors, such as differences in obesity prevalence, health care access by obese individuals, how obesity is treated and prices of health care, Cawley says.

Cawley co-authored The Impact of Obesity on Medical Costs and Labor Market Outcomes in the US with Adam Biener of the Agency for Healthcare Research and Quality and Chad Meyerhoefer of Lehigh University.